Leukoreduction May Safe Money

The practice of removing the white cells from blood is called leukoreduction. But despite the recommendations of two national advisory committees in ten years that voted in favour of all patients in the United States receiving leukoreduced blood, the practice is still not wholly supported in the medical community, nor recommended by the Food and Drug Administration.

However, Neil Blumberg, M.D., lead author of the study and a proponent of leukoreduction, argues that several cost-benefit analyses show that an upfront increase of $25 to $35 for each unit of filtered blood is offset by savings from less use of antibiotics, reduced patient time in the ICU, and shorter lengths of hospital stays overall. One study, in fact, estimated that the savings in treating heart surgery complications alone could total $1 billion a year, nationwide.

Blumberg's group reviewed approximately 520 abstracts and nine published randomised clinical trials, on the risks and benefits of using leukoreduced blood. They assessed the statistical methods that were used in each study, and found what they believed to be flawed data in some cases.

The chief problem, Blumberg's group discovered, was that some studies included hundreds of patients who never received blood transfusions. These patients would have been irrelevant to a study assessing the risks and/or benefits of certain types of transfusions, because they couldn't have benefited nor could they have been harmed by a transfusion. Furthermore, some studies used data that did not reflect actual investigative results, Blumberg said.

When the data was restricted to patients receiving transfusions, researchers found that post-surgical infection rates dropped from 33 percent to 23 percent. In other words, the relative risk of infection dropped by about 30 percent for the patients with leukoreduced blood.